New drug added to the Medication Sourcing drug list for outpatient hospitals only
Effective for dates of service on or after Jan. 1, 2023, we’re adding the following specialty medication to the specialty pharmacy requirements drug list for UnitedHealthcare commercial plans. This applies to outpatient hospitals only.
| Medication name | Therapeutic class | Code | Specialty pharmacy |
|---|---|---|---|
| Amvuttra™ | CNS agents | J3490 J3590 C9399 |
Orsini Pharmaceutical Services* |
*We will announce any additional specialty pharmacies that will supply this drug prior to Jan. 1, 2023.
Specialty pharmacy requirement
Outpatient hospitals are required to obtain the medications linked above from the indicated specialty pharmacies for distribution of these medications, unless otherwise authorized by us. In the event the specialty medication is obtained through the specialty pharmacy, the specialty pharmacy will bill us directly for these medications under the member’s medical benefit. The facility administering the specialty drug is not to bill us for the medication obtained through the specialty pharmacy.
Questions?
Please contact your Network Management or Provider Relations teams.
